{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T23:26:40Z","timestamp":1783207600836,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T00:00:00Z","timestamp":1673913600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100021360","name":"Chong Hin Loon Memorial Cancer and Biotherapy Research Center, National Yang-Ming University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100021360","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 104\u20102314\u2010B\u2010075\u2010085\u2010MY2"],"award-info":[{"award-number":["MOST 104\u20102314\u2010B\u2010075\u2010085\u2010MY2"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004663","name":"Ministry of Science and Technology, Taiwan","doi-asserted-by":"publisher","award":["MOST 105\u20102314\u2010B\u201041"],"award-info":[{"award-number":["MOST 105\u20102314\u2010B\u201041"]}],"id":[{"id":"10.13039\/501100004663","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V105E10\u2010002\u2010MY2\u20101"],"award-info":[{"award-number":["V105E10\u2010002\u2010MY2\u20101"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011912","name":"Taipei Veterans General Hospital","doi-asserted-by":"publisher","award":["V105B\u2010016"],"award-info":[{"award-number":["V105B\u2010016"]}],"id":[{"id":"10.13039\/501100011912","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009096","name":"Taiwan Clinical Oncology Research Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009096","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2023,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Frontline intensification (including consolidative whole\u2010brain radiotherapy or high\u2010dose chemotherapy with autologous stem\u2010cell transplantation after induction therapy) has been proposed to treat primary central nervous system lymphoma (PCNSL). However, no prospective randomized trials have answered whether frontline intensification can offer a survival benefit to PCNSL patients. We aim to clarify the outcomes and survival influence of frontline intensification on real\u2010world patients with different risk\u2010stratified PCNSLs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Between January 2003 and December 2016, 110 PCNSL adults were retrospectively included, and 76 patients achieved at least PR after induction therapy, including 38 patients who received frontline intensification. The median follow\u2010up with the 31 survivors was 7.52\u2009years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 38 induction\u2010completed patients who had not received frontline intensification, 95% achieved post\u2013induction therapy CR\/CRu; however, all inevitably recurred. In the 38 who received frontline intensification, CR\/CRu improved from 45% (pre\u2010frontline intensification) to 84% (post\u2010frontline intensification), and they achieved significantly better PFS (non\u2010reach vs. 522\u2009days, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001) and OS (non\u2010reach vs. 899\u2009days, <jats:italic>p<\/jats:italic>\u00a0&lt;\u20090.001). Additionally, patients had similar PFS and OS rates when receiving HDC\u2010ASCT and\/or WBRT as frontline intensification. Frontline intensification significantly improved PFS and OS survival in higher\u2010risk patients (intermediate\/high IELSG risk, MSKCC group 2\/3, or Nottingham\/Barcelona score\u2009\u2265\u20092 points) but did not improve OS in lower\u2010risk patients. Among the 38 patients who received frontline intensification, two had treatment\u2010related mortality; 14 recurred after frontline intensification. MTX\u2010based chemotherapy was the main salvage modality, and the median OS was 295\u2009days after recurrence. Progressive disease and infection (especially pneumonia) are two major causes of mortality in patients who receive frontline intensification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>When achieving CR\/CRu\/PR after induction chemotherapy, frontline intensification should be adopted to improve PFS and OS in real\u2010world PCNSL patients, especially higher\u2010risk patients.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.5607","type":"journal-article","created":{"date-parts":[[2023,1,17]],"date-time":"2023-01-17T09:54:07Z","timestamp":1673949247000},"page":"8089-8101","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Long\u2010term outcomes of frontline intensification in primary <scp>CNS<\/scp> lymphoma: A real\u2010world single\u2010center experience"],"prefix":"10.1002","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0681-0998","authenticated-orcid":false,"given":"Hao\u2010Yuan","family":"Wang","sequence":"first","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1244-9377","authenticated-orcid":false,"given":"Ching\u2010Fen","family":"Yang","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Department of Pathology and Laboratory Medicine Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-2927","authenticated-orcid":false,"given":"Chia\u2010Hsin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Linkou Chang Gung Memorial Hospital Medical Center  Taoyuan City Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liang\u2010Tsai","family":"Hsiao","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Shen","family":"Ko","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao\u2010Chung","family":"Liu","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tzeon\u2010Jye","family":"Chiou","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans General Hospital  Taipei Taiwan"},{"name":"Faculty of Medicine, School of Medicine National Yang Ming Chiao Tung University  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po\u2010Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Department of Medicine Taipei Veterans 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